POS1087 THE RELATIONSHIP BETWEEN CHANGES IN PSORIATIC ARTHRITIS DISEASE ACTIVITY AND COMORBIDITIES IN PATIENTS TREATED WITH bDMARDs
Authors: G. Ayan, N. E. Gezerer, E. Bilgin, G. K. Yardimci, E. C. Bolek, B. Farisogullari, E. Duran, Z. Özsoy, G. Sandal Uzun, M. Ekici, E. Unaldi, L. Kiliç, A. Akdogan, O. Karadag, Ş. A. Bilgen, S. Kiraz, A. İ. Ertenli, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2022)

Background Comorbidities are common in psoriatic disease, needed to be recognized and managed to effectively when treating psoriatic arthritis (PsA) patients. However, the data on the impact of particular comorbidities on the disease activity in patients requiring bDMARDs are very small. Objectives Our aim was to understand the relationship between the disease activity and comorbidities in PsA patients under bDMARDs. Methods The Hacettepe University biological database (HUR-BIO), was established in 2005 and data of 520 PsA patients included until 2021 were analyzed. In all included patients, the diagnosis of PsA was made by the rheumatologist. DAS-28 score (at the last visit) and all comorbidities were documented after bDMARD initiation. Multivariate analysis was performed to understand comorbidities that have impact on DAS-28 remission. Results There were 469 patients with a known DAS-28 score median (IQR) 28 (61) months after bDMARD initiation. It was detected in 214/469 (45.6%) patients with a DAS-28 score below 2.6. Patients in remission of DAS-28 were younger, remission was less frequent in women, and comorbidities, mainly BMI, Diabetes Mellitus (DM) and hypertension, were also found less frequent (Table 1). In the multivariate analysis, no determining factor was found in male gender. On the other hand, in females, smoking, presence of comorbidity, Body mass index (BMI) at the start of bDMARDs, age at onset of bDMARDs, DM at the start of bDMARDs, HT at the start of bDMARDs, coronary artery disease, and cardiovascular risk factors were included in the analysis and revealed, bDMARD baseline BMI [OR 1.06 (95% CI 1.02-1.11), p= 0.004] and presence of bDMARD baseline DM [OR 3.08 (95% CI 1.14-8.30), p=0.026] had significant impact on DAS-28 remission. Table 1. Relationship between remission according to DAS-28 score and comorbidities Parameters DAS-28 ≤ 2.6 (n=214 ) DAS-28 &gt; 2.6 (n=255 ) p Age, mean (SD), years 43.8 (11.7) 47.5 (12.5) 0.001 Age at PsA diagnosis, mean (SD), years 36.8 (11.5) 41.6 (11.7) &lt;0.001 Gender, female, n(%) 115 (53.7) 211 (82.7) &lt;0.001 Comorbidity count 1.54 (0.98) 1.98 (1.31) &lt;0.001 Comorbidity (yes/no) 67 (31.9) 118 (47.6) 0.001 Comorbidity distribution 0.001 -No 143 (68.1) 130 (52.4) -1 Comorbidity 38 (18.1) 47 (19.0) -≥ 2 Comorbidity 17 (8.1) 36 (14.5) -≥ 3 Comorbidity 12 (5.7) 35 (14.1) Body Mass Index (BMI) 28.1 (5.4) 30.3 (5.9) &lt;0.001 BMI &gt; 30, n(%) 70 (32.9) 123 (48.4) 0.001 Diabetes Mellitus, n(%) 10 (4.7) 35 (13.7) 0.001 Hypertension, n(%) 29 (13.6) 71 (27.8) &lt;0.001 Total cholesterol &gt; 240, n(%) 8 (10.5) 22 (28.6) 0.019 Thyroid Disease 20 (9,8) 43 (17,3) 0,02 Conclusion Previous data showed that obesity, hypertension and at least 1 point from charlson comorbidity index are poor prognositc factors for treatment outcomes (1). Our data showed that BMI and presence of DM were determined as factors affecting bDMARD treatment response in female PsA patients. References [1]Ballegaard C, et al. Comorbidities, pain and fatigue in psoriatic arthritis, psoriasis and healthy controls: a clinical cohort study. Rheumatology (Oxford). 2021 Jul 1;60(7):3289-3300. Disclosure of Interests None declared